San Jose is the largest city in America that does not fluoridate all of its drinking water. The municipal system does treat its water for about 125,000 residents, but that leaves out more than a million people served by the private San Jose water company.
The issue brought out more than 100 people to the Santa Clara Valley Water District arguing whether or not to add fluoride. On one side, people like John Pisacane, DMD, who says 50 years of evidence support the benefits of fluoride.
"When I practiced in states that had high levels of fluoride, you'd see fewer kids with a whole mouthful of cavities problem," said Dr. John Pisacane, a supporter.
Like other Bay Area cities that draw their drinking water from the Hetch Hetchy reservoir in the Sierra, San Francisco has had fluoridated water since 1972.
According to the Santa Clara Health Department, nearly a third of kindergartners and third graders in the area have tooth decay which would be reduced by adding fluoride, but opponents argue it can stain teeth, damage kidneys and lead to bone problems.
"The only hope of not getting arthritis and stiff joints from fluoride is if your kidneys are able to filter out 50 percent of what you ingest," said Maureen Jones an opponent.
Building a fluoridation system in San Jose would cost an estimated $30 million. The water company is looking toward outside groups like the Health Trust to help pay for the project.
The water company says it is not allowed to pass fluoridation costs on to customers, but it would need money from outside groups to keep a fluoridation program going. The water board is not expected to make a decision until the summer.
